Health care in Alcenia
Health care in Alcenia is provided in a complex system of state, non-profit, and for-profit providers. Health insurance is provided by Alcare, which is Alcenia's primary public health insurance option, originally available to low-income citizens, but has been expanded to cover most adult Alcenians, permanent residents, and their children. Most Alcenians, however, are covered by private insurers, the largest being AdvanceLife, Broker, Broker & Hampton, and Northway Group.
In 2018, Alcenia spent $8,331 per capita on health care. Alcenia's health care system is widely regarded to be among the best in terms of quality, but middling in terms of access. Alcenia does not have a fully universal health care program, but as of 2017, 89% of Alcenians reported they had health insurance. The average health insurance insurance premium was reported to be $5,600 per year. Rising costs of health care have contributed to early preventable deaths as a 2015 study by the University of Vellonia, La Casa Calliente showed. Furthermore, more Alcenians (11% in 2018 compared to 7% in 2014) are admitting to electing not to see a physician or ignoring health problems because they fear they cannot afford treatment. Mental health support in particular has been highlighted as point of failure in the Alcenian health care system. Alcare does not cover many medications needed to treat mental illnesses and across the country there is a severe lack of facilities equipped to deal with patients suffering from mental illness.
The typical Alcenian's life expectancy decreased for the first time in the country's history in 2018, from 81 years to 80. There is an ongoing discussion as to why this has occurred with the increasing suicide rate, opiate abuse, and lack of health care access all cited as possible contributing factors.
Health care is a contentious issue in Alcenian politics. Funding to Alcare is a common point of debate every year when the national budget is drafted. The 2019 budget, signed by President Grant Carlyle, grants Alcare a $619.7 billion budget, constituting 19.9% of Alcenia's GDP. There have been calls to create a single-payer, federally funded health care program that would cover most health care costs of Alcenians.
Health care is provided at a federal and state level. Alcare is the federal insurance program that covers 48% of Alcenians. It is basic in its coverage and is intended as a safety net. It does not cover complex surgeries, rare medications, optional or cosmetic procedures, or dental care. Depending on the recipient's income, their coverage may come with a copay to discourage frivolous use of the system. Each state has a system that expands on Alcare and seeks to fill in gaps in Alcare's coverage with state funds. Despite this, for many Alcenians, Alcare's coverage is inadequate and so they opt for a private insurer instead, which is remarkably more expensive with the average policy for a family of three costing $5,600 per year, or $466 per month. Because of high premiums, many Alcenians can only afford policies that are marginally better than Alcare's coverage, especially in the realm of pediatric coverage.
In Alcenia there were 6,330 registered hospitals. The vast majority, 68%, are non-profit or run by non-profit organizations, 25% are for-profit, and the remaining 7% are state-run. The federal government does not operate any hospitals intended for the general public, but several for members of the Armed Forces either in active duty or former enlisted.
Most hospitals and other medical facilities are owned privately. Among them, the majority are operated as non-profits and often perform medical work for free in order to write the expense off their tax liability. These non-profits are funded by insurance providers of their patients and by the copays their patients are typically required to pay under their policy. Alcare only pays out benefits to non-profit providers meaning for-profit hospitals do not accept Alcare.